myosesh Musculoskeletal post Is your Pelvis tilting laterally? This is what you need to do

Is your Pelvis tilting laterally? This is what you need to do

Lateral pelvic tilt is waist height difference and either hip drops or hikes.

Also, it is called an uneven hip.

Aetiology

  • Standing on one side (lean on one side while standing)
  • Leg length difference
  • Tight muscles (Quadratus Lumborum, Gluteus medius, minimus, and Tensor fascia Latta, hip adductors, abdominal muscles)
  • Crossed leg sitting
  • Wear improper shoes
  • Injury such as a sprained ankle and damaged ligament in knee and ankle
  • Born with a short leg
  • Neurological condition like a drop foot

How do we assess if you have uneven hips?

1.    Standing position

  • If the heel is on the ground
  • If the knees are straight
  • If the hip height is different
  • If the body weight is on one side
  • Trendelenburg sign (special test to see if there is weak gluteus medius and minimus) https://www.youtube.com/watch?v=0rcczDEWDqU
  • If there is scoliosis or not (S shape or opposite S shape)
  • Check the height of PSIS and ischial tuberosity when flex (bend forward)

2.    Supine position (face up)

  • Check medial malleolus which is the bone located in inner side of ankle (which one is higher)
  • Check pelvis (hip bone) height 
  • Knees bent at 45 degrees, feet on the ground then see the length from hip to knees (femur)
  • Put fingers on ASIS if the height is same

Treatment

Release the tight muscles when left hip hikes

Left QL, hip adductors, external and internal oblique need to be loosened up

Right TFL, gluteus medius and minimus need to be worked on.

· To release the muscles, see practitioners or a spiky ball or a foam roller can be used.

Stretch muscles

Adductor stretch: this can be done either sitting or lie down

· Make a figure four with legs (put out side of the ankle on the other isde of thigh)

· Bring it to as close to your body as possible 

· You should feel stretching inside and back of your leg

· Hold it where you feel stretch for 30secs and repeat 2-3 times

Adductors stretch 2

· Sit down on the floor

·Simply open the legs as far as you can

· Bend forward as far as possible (try to keep the toes up )

· Hold it there for 30 secs and repeat 2-3times

Quadratus Lumborum stretch: this can be done by either seated or standing

· Standing version: Grab something like a pole or wall

· Bend your body sideways and bring the legs away from your hand that is holding something

· You should feel stretching the opposite side of lower back muscle 

· Keep it there for 30 secs and repeat 2-3 times

·Seated version: sit on the chair or the floor.

·Put your arm straight and next to the ear, the other side is on the chair or the floor to support your body

· Bend the body sideways towards the side you are supporting your body

· Make sure your hip is not in the air

·Keep it for 30 secs and repeat 2-3 times

Glutes medius and minimus

· Sit on the ground with legs straight

·Bend one side of the knee and put foot outside of the other leg

·Use opposite side of hand to pull the bent side of the leg

· Keep it for 30 secs and repeat 2-3 times

TFL stretch

· Lunge position

· Bring back leg towards body as far as possible

·Bend body to the side of front leg

· Should feel stretching just below ASIS

· Hold it there 30secs and repeat 2-3 times

Strengthen training

Gluteus Medius half-open shell

·Side-lying, knee bent at 45 degrees, put a rolled towel or roller between knees and inside of feet together

·Palpate gluteus medius and minimus to focus on those muscles

· Bring upper knee away just 2-3cm make sure at least heels are together

·Pushing upper heel to lower heel is a trick to fire on glutes med and min

·Make sure to fire on the muscles and rest completely each reps

· Repeat 15-20times until you feel firing muscles

Balance ball press

·Stand in parallel to the wall and put a balance ball between the wall and leg where you want to train

· Bend the knee and push the ball towards the wall (can be done by pushing straight to the wall and open the knee 2-3cm)

· Make sure to fire on the muscles and rest completely each reps

·Repeat 15-20 times (Muscles need to be fired on)

QL and external oblique exercise (oblique crunches) Right side

·This can be done by standing or seated

·Bend sideways (to the left) with holding a kettle bell or barbell

· Could be rotated (bend backwards) *do not do it when you get a lower back pain

·Focus on the external oblique and QL to pull up and down (especially when the muscle stretches)

·Repeat 12-15times 2-3reps

Adductors (exercise ball)

· Either seated or standing

· Put the ball between legs above knees

·Push into the ball then relax (Or keep pushing 8-10 secs and relax)

·Repeat this 10times and 2-3reps

Adductor (A thera band)

·Use a circled band or make it a circle

·Put one leg in the circle and hold the other side with a pole or something cannot move

· Pull a band towards the other side of the leg

·Pull a leg to both front and back of the other leg (As adductor magnus does extension of the hip too) ·Repeat this 10times 2-3reps

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